A space to shoot up, but no space for addiction treatment

Jonathan worries he may die before getting into an Ottawa treatment bed.

The 24-year-old has been going to the unauthorized supervised injection site since it opened this summer.

But for the last 10 days he's been coming to the Overdose Prevention Ottawa tents in Raphael Brunet Park looking for something more. He's been asking for help getting into treatment for his addiction.  

A volunteer at the tent, Matthew St. Jean, a recovering addict himself, has been calling the Ottawa Withdrawal Management Centre, to get Jonathan into one of 26 beds that serve the entire region from Pembroke to Cornwall.

26 detox beds not enough: advocates

The centre helps with withdrawal, and acts as one of the gateways into a longer-term program in a residential treatment facility.

St. Jean made a number of calls during an interview with CBC News, but each call went directly to voicemail.

St. Jean said he recently had success getting through for a user, only to find by the time the person got to the centre, the bed was gone.

"We're making the calls and making the calls," said St. Jean, who explained he's been trying to get Jonathan in for almost two weeks.

"He was good for the two weeks, but it's a slippery slope," he said. "You could end up using again. There's definitely not enough resources in Ottawa, at all."

Spending more on injection sites, less on treatment 

The Ontario government announced $222 million over three years in new spending to help communities' treatment and harm reduction strategies as a response to the opioid crisis.

• Ottawa Public Health referring drug users to unsanctioned safe injection site

So far in Ottawa, close to $2 million has been spent on harm reduction strategies to stem the alarming tide of overdoses.

The money has been used to supply naloxone and training for first responders, as well as opening up supervised injection sites.

As for actual treatment, to date, $265,000 has been spent to hire a couple of counsellors, a nurse and a nurse practitioner for community-based services.

No new treatment beds are expected to open. 

"We need to move fast on this," said Kevin Barclay, a director with the Champlain Local Health Integration Network, noting more money is expected for treatment.

"You can more effectively and rapidly deploy human resources than you can build beds."

Meanwhile, the province is spending close to $2 million on harm-reduction strategies, such as opening supervised injection sites as well as training and equipping first responders with the antidote naloxone, used in overdose emergencies, according to data obtained by CBC News.

Many of the people working closest with injection drug users argue the emphasis on harm reduction is critical, since saving lives must be the priority.

But some advocates want to see more commitment to treatment, and the longer-term fix. 

"When it comes to cancer, heart institute, eye institute, pediatrics, CHEO, the sky's the limit," said addiction specialist Dr. Mark Ujjainwalla. "But for [addiction treatment] what they're telling taxpayers is these people are hopeless, they will never get better, and the best we can do for them is let them inject."

Ujjainwalla runs Recovery Ottawa, a methadone clinic serving some 1,500 patients seeking treatment.

But using methadone as an alternative drug to avoid more harmful drugs like heroin and fentanyl is just the beginning of a successful, long-term treatment plan, according to Ujjainwalla.

Months to get services when patients need help now

Ujjainwalla said finding patients access to psychiatric or psychological services, pain clinics, outpatient addiction services or treatment beds can mean months of waiting. In the case of the pain management clinic at the Ottawa Hospital, the wait is from six months to a year.

Ujjainwalla said a flow chart of someone who needs help now always leads to the same outcome.

"Unfortunately, you always end up back on the street, or the emergency room, or jail or dead. So, those are your outcomes," he said.

"Which is very sad, and it makes me as an addiction physician feel very badly for these people because they have a treatable illness."

'I'll probably die'

"My worst fear now is getting denied," said Jonathan, who has been shooting heroin for the last eight months.

Jonathan has been trying to stay off drugs on his own for the last 10 days, but his abstinence is fragile.

Four days ago he broke down and shot up again.

Still, he hasn't given up. But if he doesn't get into a treatment bed soon, he's afraid of what could happen.

"I'll gradually get worse. I'll probably die … That's my only thing I'm looking forward to is getting clean."